Expanding Role of Nephron-Sparing Surgery in Non-syndromic Unilateral Unifocal Wilm's Tumor-Our Experience and Review of Literature.
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Wilms' tumor is the most common renal malignancy in the pediatric age group. The unilateral type is the most prevalent, with a tenth of cases being a part of genetic malformation syndromes. The majority of Wilms' tumors are detected by chance detection of abdominal mass on ultrasound. Treatment protocols established by the Renal Tumor Committee of the Children's Oncology Group (COG) in North America and the International Society of Pediatric Oncology (SIOP) in Europe emphasize approaches such as surgical resection, neoadjuvant chemotherapy, and, in rare cases, irradiation. Radical nephrectomy with lymph node sampling forms the mainstay in the management of unilateral Wilms' tumor (uWT). Nephron-sparing surgery (NSS) is becoming increasingly popular for unilateral pediatric cases due to its ability to preserve functional renal tissue. This article reviews various recent studies that explored the role of NSS in uWT. Additionally, two case studies involving NSS for uWT and their outcomes are presented. This study found that factors such as the timing and duration of neoadjuvant chemotherapy, tumor mass size, presence of tumor margins, and intraoperative ischemia time significantly influenced the outcome of NSS.